Why is this medication prescribed?

Atezolizumab is a type of immunotherapy used to treat certain types of cancer. It works by targeting and blocking a protein called PD-L1 (programmed death-ligand 1), which helps cancer cells evade the immune system. By inhibiting this protein, atezolizumab helps the immune system recognize and attack cancer cells more effectively. It is prescribed for conditions such as:

• Non-small cell lung cancer (NSCLC): It can be used for advanced or metastatic NSCLC, either alone or in combination with other medications.
• Urothelial carcinoma: This is a type of bladder cancer. Atezolizumab is used for advanced or metastatic cases.
• Triple-negative breast cancer (TNBC): It is prescribed for certain cases of this aggressive breast cancer, particularly when it is locally advanced or metastatic.
• Hepatocellular carcinoma (HCC): For liver cancer, especially when other treatments have not been effective.

The exact use and dosage depend on the specific type of cancer, its stage, and other individual factors.

How should this medicine be used?

Atezolizumab is administered by injection into a vein (intravenously) by a healthcare professional. Here’s a general overview of how it is used:

• Dosage and Schedule: The dosage and schedule of atezolizumab can vary depending on the type of cancer being treated, the specific treatment plan, and the patient’s overall health. It is typically given once every 2 or 3 weeks.
• Administration: The injection is usually given in a healthcare setting, such as a hospital or clinic. The infusion typically lasts about 30 to 60 minutes, but the duration can vary.
• Preparation: Atezolizumab comes as a liquid that is diluted and prepared for infusion by a healthcare professional. The healthcare team will monitor you during the infusion and for some time afterward for any immediate reactions.
• Monitoring: Regular blood tests and medical evaluations are required to monitor for side effects and assess how well the treatment is working. Your healthcare provider will provide you with specific instructions based on your treatment plan.
• Adherence: It’s crucial to adhere to the scheduled infusions and follow any additional instructions from your healthcare provider to ensure the effectiveness of the treatment.

If you have any specific concerns or questions about your treatment with atezolizumab, discussing them with your oncologist or healthcare provider is important. They can give you detailed instructions tailored to your situation.

Other uses for this medicine

• Melanoma: Clinical trials are evaluating its efficacy in treating melanoma, particularly in combination with other therapies.
• Head and Neck Squamous Cell Carcinoma (HNSCC): Research is ongoing to determine its effectiveness for this type of cancer.
• Endometrial Carcinoma: Atezolizumab is being investigated for use in treating certain types of endometrial cancer.

What special precautions should I follow?

Special Precautions for Atezolizumab Injection:

• Immune-Related Side Effects: Atezolizumab can cause immune-related side effects because it enhances the immune system’s activity. These can include inflammation of various organs such as the lungs (pneumonitis), liver (hepatitis), kidneys (nephritis), and intestines (colitis). Report any symptoms like persistent cough, shortness of breath, abdominal pain, or severe diarrhea to your healthcare provider immediately.
• Allergic Reactions: Severe allergic reactions, though rare, can occur. Symptoms might include rash, itching, swelling, severe dizziness, or trouble breathing. Immediate medical attention is needed if these symptoms occur.
• Infections: Since atezolizumab affects the immune system, there may be an increased risk of infections. Maintain good hygiene and consult your healthcare provider if you develop signs of infection.
• Autoimmune Disorders: If you have a history of autoimmune disorders, inform your healthcare provider, as atezolizumab may exacerbate these conditions.
• Pre-existing Conditions: Inform your healthcare provider about any pre-existing health conditions, particularly related to the liver, kidneys, or lungs, as these may affect the treatment and management of side effects.
• Pregnancy and Breastfeeding: Atezolizumab is not recommended during pregnancy as it may harm the fetus. Use effective contraception during treatment and consult your healthcare provider if you are pregnant or planning to become pregnant. It’s also unknown whether atezolizumab passes into breast milk, so discuss breastfeeding with your provider.
• Drug Interactions: Inform your healthcare provider about all other medications you are taking, including over-the-counter drugs, vitamins, and supplements, as they might interact with atezolizumab.
• Monitoring: Regular monitoring and follow-up appointments are essential to manage potential side effects and assess the effectiveness of the treatment.

Always follow the guidance of your healthcare provider and report any unusual symptoms or side effects promptly.

What special dietary instructions should I follow?

There are no specific dietary restrictions associated with atezolizumab. However, maintaining a balanced diet can help support overall health and may aid in managing side effects. It’s always a good idea to discuss any dietary concerns with your healthcare provider, especially if you experience nausea or other gastrointestinal symptoms.

What should I do if I forget a dose?

• Missed Dose: If you miss an appointment for your atezolizumab infusion, contact your healthcare provider as soon as possible. They will reschedule your dose and provide guidance on how to proceed.
• Timing of Next Dose: Follow your healthcare provider’s instructions on when to resume treatment. Do not attempt to make up for a missed dose by doubling up or adjusting your schedule on your own.
• Record Keeping: Keep track of your infusion schedule and any missed appointments to ensure timely rescheduling and adherence to your treatment plan.

What side effects can this medication cause?

Atezolizumab can cause a range of side effects, some of which can be serious. Common side effects include:

Common Side Effects:

• Fatigue: Feeling tired or weak.
• Nausea: Feeling sick to your stomach.
• Loss of Appetite: Decreased interest in eating.
• Fever: Elevated body temperature.
• Chills: Feeling cold or shivery.
• Rash: Skin changes or eruptions.
• Joint Pain: Discomfort or pain in the joints.

Serious Side Effects:

• Pneumonitis: Inflammation of the lungs, which can cause symptoms like cough, shortness of breath, and chest pain.
• Hepatitis: Inflammation of the liver, which may lead to jaundice (yellowing of the skin and eyes), dark urine, and abdominal pain.
• Nephritis: Inflammation of the kidneys, potentially leading to symptoms like decreased urine output, blood in urine, or swelling.
• Colitis: Inflammation of the colon, which can cause severe diarrhea, abdominal pain, and blood in stool.
• Thyroiditis: Inflammation of the thyroid gland, potentially causing hyperthyroidism or hypothyroidism, with symptoms like weight changes, mood swings, and changes in energy levels.
• Adrenalitis: Inflammation of the adrenal glands, leading to symptoms like fatigue, weight loss, and abdominal pain.
• Infusion-Related Reactions: Symptoms occurring during or shortly after infusion, such as fever, chills, nausea, or rash.
• Severe Allergic Reactions: Such as rash, itching, swelling, severe dizziness, or trouble breathing.
• Infections: Increased risk of infections due to immune system effects.

Contact your healthcare provider if you experience any severe symptoms or side effects, especially those related to immune-related reactions or allergic reactions. Attend all scheduled appointments for monitoring and management of side effects.

Your healthcare provider can offer the best guidance on managing side effects and what to look out for.

What should I know about storage and disposal of this medication?

Storage and Disposal of Atezolizumab Injection:

• Storage:
  • Atezolizumab comes as a liquid in a vial and is prepared for infusion by a healthcare professional. It should be stored according to the manufacturer’s instructions, which generally involve refrigeration.
  • Store unopened vials in the refrigerator at 2°C to 8°C (36°F to 46°F). Do not freeze.
  • Protect the vials from light. If the vial is exposed to light, check the manufacturer’s guidelines for how long it can be used.
• Disposal:
  • Disposal of used vials and any leftover medication should be done according to the healthcare facility’s procedures and local regulations. It is typically handled by medical professionals to ensure proper disposal and minimize environmental impact.
  • If you have leftover medication or empty vials at home, consult with your healthcare provider or local pharmacy for proper disposal methods. Do not dispose of medications in household trash or flushing them down the toilet unless specifically instructed.

In case of emergency/overdose

• Emergency Symptoms: In the event of an allergic reaction or severe side effects (such as difficulty breathing, swelling, severe rash, or signs of an infection), seek immediate medical attention.
• Contact Emergency Services: Call emergency services or go to the nearest emergency room if you experience severe symptoms or an allergic reaction.
• Symptoms of Overdose: An overdose of atezolizumab is unlikely because it is administered in a controlled setting, but symptoms of overdose might include exaggerated side effects. Contact your healthcare provider immediately if you suspect an overdose.
• Medical Intervention: Your healthcare provider will provide treatment based on the specific symptoms and severity.

What other information should I know?

• Inform Your Provider: Keep your healthcare provider informed about all medications you are taking and any pre-existing health conditions.
• Follow Instructions: Adhere strictly to your treatment plan, including infusion schedules and follow-up appointments.
• Ongoing Studies: Atezolizumab is being studied for other types of cancers and treatment combinations. Ask your healthcare provider about any relevant clinical trials that might be suitable for you.
• Patient Support: Many cancer centers offer patient support services, including counseling, financial assistance, and educational resources. Utilize these resources to help manage your treatment.

Always consult with your healthcare provider for personalized advice and information about managing your treatment with atezolizumab.